The authors performed a systematic review of randomized controlled trials comparing H. pylori eradication with placebo or another drug treatment. Results were incorporated into a Markov model comparing health service costs and benefits of H. pylori eradication with antacid treatment over one year.
One dyspeptic cured for every 15 people treated.
Twelve trials were included in the systematic review, nine of which evaluated dyspepsia at 3-12 months in 2541 patients.
H. pylori eradication treatment was significantly superior to placebo in treating non-ulcer dyspepsia (relative risk reduction 9% [95% confidence interval 4% to 14%]), one case of dyspepsia being cured for every 15 people treated. H. pylori eradication cost £56 per dyspepsia-free month during first year after treatment.
Paul Moayyedi concludes, "H. pylori eradication may be cost effective treatment for non-ulcer dyspepsia in infected patients, but further evidence is needed on decision makers' willingness to pay for relief of dyspepsia".
In an accompanying BMJ editorial, Dr Sander Veldhuyzen van Zanten from Halifax, Canada, suggests that slightly better results might be obtained in General Practice. For dyspeptics below 50-55 years, he recommends a test for H. pylori and treat policy.
What will this week's Maastricht II conference recommend?